WILDSTATE LAWTON LLC - NPI 1043188261 - Durable Medical Equipment & Medical Supplies in Lawton, OK

Q: What is Wildstate Lawton LLC's NPI number?

The NPI number for Wildstate Lawton LLC is 1043188261. It was assigned to this organization in the NPPES registry on October 28, 2025.

Q: What is Wildstate Lawton LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

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About Wildstate Lawton Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILDSTATE LAWTON LLC (NPI 1043188261) is a healthcare organization registered as a durable medical equipment & medical supplies in Lawton, Oklahoma and active in the NPI registry since October 2025. The organization holds a CLIA Waiver certificate valid through February 17, 2028 and lists Crystal Michelle Johnson, Owner, as its authorized official.

NPPES Registry Identity

NPI1043188261

Entity TypeOrganization

Primary Taxonomy332B00000X

Legal Business NameWILDSTATE LAWTON LLC

Location Address2504 SW LEE BLVDLawton, OK 73505-8311

Mailing Address2504 Sw Lee BlvdLawton, OK 73505-8311 · (580) 250-1999

Phone(580) 250-1999

Organization SubpartYes

Authorized OfficialCrystal Michelle JohnsonOwner · (580) 280-2558

Enumeration DateOctober 28, 2025

Last NPPES UpdateNovember 18, 2025

NPPES CertifiedNovember 18, 2025

✔ NPI 1043188261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers

Taxonomy Code332B00000X

Definition

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

2504 SW LEE BLVD, Lawton, OK 73505

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Other Identifiers 1

Other1467327759OK · Dbacombinedhomemedical

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D2338823

Wildstate Lawton LLC · Lawton, OK

Active · expires Feb 17, 2028

CLIA Number37D2338823

Laboratory TypePhysician Office

Certificate Effective DateFebruary 18, 2026

Certificate Expiration DateFebruary 17, 2028

Laboratory DirectorCourtnie Alberry-Minnear

Laboratory Phone(580) 280-2558

Laboratory LocationWildstate Lawton LLC2506 SW Lee Blvd, Lawton, OK 73505

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHNSON MEDICAL CONSULTING, INC.

Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)

2504 SW LEE BLVD
LAWTON, OK 73505

Comanche County (580) 250-1999

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wildstate Lawton LLC's NPI number?

The NPI number for Wildstate Lawton LLC is 1043188261. It was assigned to this organization in the NPPES registry on October 28, 2025.

Where is Wildstate Lawton LLC located?

Wildstate Lawton LLC is located at 2504 SW Lee Blvd, Lawton, OK 73505. The listed phone number is (580) 250-1999.

What is Wildstate Lawton LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Wildstate Lawton LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2338823) is associated with this NPI, valid through February 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wildstate Lawton LLC was last updated on November 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.